Guidelines for managing anaphylaxis in children need an update

A new study led by AllerGen researcher Dr. Moshe Ben-Shoshan suggests that treatment guidelines for managing anaphylaxis in children should be reassessed, and shows that pre-hospital treatment with epinephrine has the greatest protective effect against uncontrolled allergic reactions.

The research, published in the Journal of Allergy and Clinical Immunology: In Practice, involved nearly 3,500 patients, making it the largest study to assess the clinical outcomes of pre-hospital treatment of anaphylaxis. Of the patients examined, 80% were children aged one to 17 years. The patient data derived from AllerGen’s nationwide Cross-Canada Anaphylaxis REgistry (C-CARE) project, involving nine emergency departments in five provinces.

“We found that steroids, which are part of the treatment plan for managing anaphylaxis, can have a negative effect on patient outcomes,” says Dr. Ben-Shoshan.

“Our study also shows that the use of an epinephrine autoinjector in the pre-hospital setting has a significant positive impact on the clinical management of anaphylaxis—a much more significant protective effect than that achieved with antihistamines,” adds first author and AllerGen trainee Sofianne Gabrielli.

According to the researchers, these results suggest that current anaphylaxis management practices should be modified, at least as applies to the pre-hospital setting, to exclude steroids and to call for the administration of antihistamines only in conjunction with epinephrine in all cases of anaphylaxis.

“The findings from this study reinforce the need to equip individuals with the knowledge and confidence to assess the signs and symptoms of anaphylaxis, and to treat it swiftly with an epinephrine autoinjector when it occurs,” comments Jennifer Gerdts, a study co-author and Executive Director of Food Allergy Canada.

Press release

See Sofianne Gabrielli interviewed about this research on Global TV